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Novel genetic loci affecting facial shape variation inhumansJournal ItemHow to cite:
Xiong, Ziyi; Dankova, Gabriela; Howe, Laurence J.; Lee, Myoung Keun; Hysi, Pirro G.; de Jong, Markus A.;Zhu, Gu; Adhikari, Kaustubh; Li, Dan; Li, Yi; Pan, Bo; Feingold, Eleanor; Marazita, Mary L.; Shaffer, John R.;McAloney, Kerrie; Xu, Shu-Hua; Jin, Li; Wang, Sijia; de Vrij, Femke M. S.; Lendemeijer, Bas; Richmond, Stephen;Zhurov, Alexei; Lewis, Sarah; Sharp, Gemma C.; Paternoster, Lavinia; Thompson, Holly; Gonzalez-Jose, Rolando;Bortolini, Maria Catira; Canizales-Quinteros, Samuel; Gallo, Carla; Poletti, Giovanni; Bedoya, Gabriel; Rothhammer,Francisco; Uitterlinden, André G.; Ikram, M. Arfan; Wolvius, Eppo; Kushner, Steven A.; Nijsten, Tamar E. C.; Palstra,Robert-Jan T. S.; Boehringer, Stefan; Medland, Sarah E.; Tang, Kun; Ruiz-Linares, Andrés; Martin, Nicholas G.;Spector, Timothy D.; Stergiakouli, Evie; Weinberg, Seth M.; Liu, Fan and Kayser, Manfred (2019). Novel genetic lociaffecting facial shape variation in humans. eLife, 8 pp. 1–32.
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†These authors also contributed
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Present address: §Department
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authors declare that no
competing interests exist.
Funding: See page 23
Received: 03 July 2019
Accepted: 22 November 2019
Published: 26 November 2019
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Novel genetic loci affecting facial shapevariation in humansZiyi Xiong1,2,3†, Gabriela Dankova1†, Laurence J Howe4, Myoung Keun Lee5,Pirro G Hysi6, Markus A de Jong1,7,8§, Gu Zhu9, Kaustubh Adhikari10, Dan Li11,12,13,Yi Li3, Bo Pan14, Eleanor Feingold5, Mary L Marazita5,15, John R Shaffer5,15,Kerrie McAloney9, Shu-Hua Xu11,12,13,16,17, Li Jin11,12,13,18,19, Sijia Wang11,12,13,17,Femke MS de Vrij20, Bas Lendemeijer20, Stephen Richmond21, Alexei Zhurov21,Sarah Lewis4, Gemma C Sharp4,22, Lavinia Paternoster4, Holly Thompson4,Rolando Gonzalez-Jose23, Maria Catira Bortolini24, Samuel Canizales-Quinteros25,Carla Gallo26, Giovanni Poletti26, Gabriel Bedoya27, Francisco Rothhammer28,Andre G Uitterlinden2,29, M Arfan Ikram2, Eppo Wolvius7, Steven A Kushner20,Tamar EC Nijsten30, Robert-Jan TS Palstra31, Stefan Boehringer8,Sarah E Medland9, Kun Tang11,12,13, Andres Ruiz-Linares18,19,32, Nicholas G Martin9,Timothy D Spector6‡, Evie Stergiakouli4,22‡, Seth M Weinberg5,15,33‡, Fan Liu1,3‡*,Manfred Kayser1‡*, On behalf of the International Visible Trait Genetics (VisiGen)Consortium
1Department of Genetic Identification, Erasmus MC University Medical CenterRotterdam, Rotterdam, Netherlands; 2Department of Epidemiology, Erasmus MCUniversity Medical Center Rotterdam, Rotterdam, Netherlands; 3CAS KeyLaboratory of Genomic and Precision Medicine, Beijing Institute of Genomics,University of Chinese Academy of Sciences (CAS), Beijing, China; 4Medical ResearchCouncil Integrative Epidemiology Unit, Population Health Sciences, University ofBristol, Bristol, United Kingdom; 5Center for Craniofacial and Dental Genetics,Department of Oral Biology, University of Pittsburgh, Pittsburgh, United States;6Department of Twin Research and Genetic Epidemiology, King’s College London,London, United Kingdom; 7Department of Oral & Maxillofacial Surgery, SpecialDental Care, and Orthodontics, Erasmus MC University Medical Center Rotterdam,Rotterdam, Netherlands; 8Department of Biomedical Data Sciences, LeidenUniversity Medical Center, Leiden, Netherlands; 9QIMR Berghofer Medical ResearchInstitute, Brisbane, Australia; 10Department of Genetics, Evolution, andEnvironment, University College London, London, United Kingdom; 11CAS KeyLaboratory of Computational Biology, Chinese Academy of Sciences (CAS),Shanghai, China; 12CAS-MPG Partner Institute for Computational Biology (PICB),Chinese Academy of Sciences (CAS), Shanghai, China; 13Shanghai Institute ofNutrition and Health, Shanghai Institutes for Biological Sciences, Chinese Academyof Sciences (CAS), Shanghai, China; 14Department of Auricular Reconstruction,Plastic Surgery Hospital, Beijing, China; 15Department of Human Genetics,University of Pittsburgh, Pittsburgh, United States; 16School of Life Science andTechnology, ShanghaiTech University, Shanghai, China; 17Center for Excellence inAnimal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China;18State Key Laboratory of Genetic Engineering, School of Life Sciences, FudanUniversity, Shanghai, China; 19Ministry of Education Key Laboratory ofContemporary Anthropology, School of Life Sciences, Fudan University, Shanghai,China; 20Department of Psychiatry, Erasmus MC University Medical CenterRotterdam, Rotterdam, Netherlands; 21Applied Clinical Research and Public Health,
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 1 of 32
RESEARCH ARTICLE
University Dental School, Cardiff University, Cardiff, United Kingdom; 22School ofOral and Dental Sciences, University of Bristol, Bristol, United Kingdom; 23InstitutoPatagonico de Ciencias Sociales y Humanas, CENPAT-CONICET, Puerto Madryn,Argentina; 24Departamento de Genetica, Universidade Federal do Rio Grande doSul, Porto Alegre, Brazil; 25UNAM-Instituto Nacional de Medicina Genomica,Facultad de Quımica, Unidad de Genomica de Poblaciones Aplicada a la Salud,Mexico City, Mexico; 26Laboratorios de Investigacion y Desarrollo, Facultad deCiencias y Filosofıa, Universidad Peruana Cayetano Heredia, Lima, Peru; 27GENMOL(Genetica Molecular), Universidad de Antioquia, Medellın, Colombia; 28Instituto deAlta Investigacion, Universidad de Tarapaca, Arica, Chile; 29Department of InternalMedicine, Erasmus MC University Medical Center Rotterdam, Rotterdam,Netherlands; 30Department of Dermatology, Erasmus MC University Medical CenterRotterdam, Rotterdam, Netherlands; 31Department of Biochemistry, Erasmus MCUniversity Medical Center Rotterdam, Rotterdam, Netherlands; 32Aix-MarseilleUniversite, CNRS, EFS, ADES, Marseille, France; 33Department of Anthropology,University of Pittsburgh, Pittsburgh, United States
Abstract The human face represents a combined set of highly heritable phenotypes, but
knowledge on its genetic architecture remains limited, despite the relevance for various fields. A
series of genome-wide association studies on 78 facial shape phenotypes quantified from 3-
dimensional facial images of 10,115 Europeans identified 24 genetic loci reaching study-wide
suggestive association (p < 5 � 10�8), among which 17 were previously unreported. A follow-up
multi-ethnic study in additional 7917 individuals confirmed 10 loci including six unreported ones
(padjusted < 2.1 � 10�3). A global map of derived polygenic face scores assembled facial features in
major continental groups consistent with anthropological knowledge. Analyses of epigenomic
datasets from cranial neural crest cells revealed abundant cis-regulatory activities at the face-
associated genetic loci. Luciferase reporter assays in neural crest progenitor cells highlighted
enhancer activities of several face-associated DNA variants. These results substantially advance our
understanding of the genetic basis underlying human facial variation and provide candidates for
future in-vivo functional studies.
IntroductionThe human face represents a multi-dimensional set of correlated, mostly symmetric, complex pheno-
types with high heritability. This is illustrated by a large degree of facial similarity between monozy-
gotic twins and, albeit less so, between other relatives (Djordjevic et al., 2016), stable facial
features within and differences between major human populations, and the enormous diversity
among unrelated persons almost at the level of human individualization. Understanding the genetic
basis of human facial variation has important implications for several disciplines of fundamental and
applied sciences, including human genetics, developmental biology, evolutionary biology, medical
genetics, and forensics. However, current knowledge on the specific genes influencing human facial
appearance and the underlying molecular mechanisms forming facial morphology is limited.
Over recent years, nine separate genome-wide association studies (GWASs) have each
highlighted several but largely non-overlapping genetic loci associated with facial shape phenotypes
(Adhikari et al., 2016; Cha et al., 2018; Claes et al., 2018; Cole et al., 2016; Lee et al., 2017;
Liu et al., 2012; Paternoster et al., 2012; Pickrell et al., 2016; Shaffer et al., 2016). The overlap-
ping loci from independent facial GWASs, thus currently representing the most established genetic
findings, include DNA variants in or close to 10 genes that is CACNA2D3 (Paternoster et al., 2012;
Pickrell et al., 2016), DCHS2 (Adhikari et al., 2016; Claes et al., 2018), EPHB3 (Claes et al., 2018;
Pickrell et al., 2016), HOXD cluster (Claes et al., 2018; Pickrell et al., 2016), PAX1 (Adhikari et al.,
2016; Shaffer et al., 2016), PAX3 (Adhikari et al., 2016; Claes et al., 2018; Liu et al., 2012;
Paternoster et al., 2012; Pickrell et al., 2016), PKDCC (Claes et al., 2018; Pickrell et al., 2016),
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 2 of 32
Research article Genetics and Genomics
SOX9 (Cha et al., 2018; Claes et al., 2018; Pickrell et al., 2016), SUPT3H (Adhikari et al., 2016;
Claes et al., 2018; Pickrell et al., 2016), and TBX15 (Claes et al., 2018; Pickrell et al., 2016), which
were identified mostly in Europeans.
Indicated by the small effect size of the previously identified face-associated DNA variants,
together with the high heritability of facial phenotypes, the true number of genes that influence
polygenetic facial traits is likely to be much larger than currently known. Despite the previous work,
our understanding of the complex genetic architecture of human facial morphology thus remains
largely incomplete. This emphasizes on the need for well-powered GWASs that can be achieved
through large collaborative efforts, which has been recently demonstrated for appearance traits
involving pigmentation variation (Hysi et al., 2018; Visconti et al., 2018), but is currently missing
for the human face.
A most recent study (Claes et al., 2018) suggested that variants at genetic loci implicated in
human facial shape are involved in the epigenetic regulation of human neural crest cells, suggesting
that at least some of the functional variants may reside within regulatory elements such as enhancers.
Although this is in line with evidence for other appearance phenotypes such as human pigmentation
traits, where experimental studies have proven enhancer effects of pigmentation-associated DNA
variants (Visser et al., 2012; Visser et al., 2014; Visser et al., 2015), experimental evidence for
understanding the functional basis of DNA variants for which facial phenotype associations have
been previously established is missing as of yet.
Led by the International Visible Trait Genetics (VisiGen) Consortium and together with its study
partners, the current study represents a collaborative effort to identify novel genetic variants
involved in human facial variation in the largest set of multi-ethnic samples available thus far. More-
over, it demonstrates the functional consequences of identified face-associated DNA variants based
on in-silico work and in-vitro experimental evidence.
Results
Facial phenotypesThe current study included seven cohorts, totaling 18,032 individuals. Demographic characteristics
and phenotyping details for all cohorts are provided in Materials and methods and
Supplementary file 1 - Table 1. A variety of different phenotyping methods are available for 3D
facial image data, where some approaches (Claes et al., 2018) require access to the underlying raw
image datasets, which often cannot be shared between different research groups. In order to maxi-
mize sample size via a collaborative study, we focused on linear distance measures of facial features
that can be accurately derived from facial image datasets. In our cohorts with 3D facial surface
images, we focused on distances between a common set of thirteen well-defined facial landmarks
(Figure 1). In the Rotterdam Study (RS) and the TwinsUK study (TwinsUK), we used the same ensem-
ble method for automated 3D face landmarking that was specifically designed for large cohort stud-
ies with the flexibility of landmark choice and high robustness in dealing with various image qualities
(de Jong et al., 2018; de Jong et al., 2016). Facial landmarking in Avon Longitudinal Study of
Parents and their Children (ALSPAC) and Pittsburgh 3D Facial Norms study (PITT) was done manu-
ally. Generalized Procrustes Analysis (GPA) was used to remove affine variations due to shifting,
rotation and scaling (Figure 1—figure supplement 1). A total of 78 Euclidean distances involving all
combinatorial pairs of the 13 facial landmarks were considered as facial phenotypes.
Detailed phenotype analyses were conducted in RS. In RS, almost all (72 out of 78, 92%,) of the
facial phenotypes followed the normal distribution as formally investigated by applying the Shapiro-
Wilk normality test and obtaining non-significant results (Supplementary file 1 - Table 2). For only
six phenotypes, this test revealed significant results; however, their histogram looked largely normal.
A highly significant sex effect (min p=2.1 � 10�151) and aging effect (min p=8.0 � 10�44) were
noted, together explained up to 21% of the variance per facial phenotype (e.g. between alares and
Ls; Figure 1—figure supplement 2A–2C, Supplementary file 1 - Table 3). Intra-organ facial pheno-
types (e.g. within nose or within eyes) showed on average higher correlations than inter-organ ones
(e.g. between nose and eyes), and symmetric facial phenotypes showed higher correlations than
non-symmetric ones. Genetic correlations (Zhou and Stephens, 2014) estimated using genome-
wide data were similar to correlations obtained directly from phenotype data, with on average
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 3 of 32
Research article Genetics and Genomics
higher absolute values seen based on genotypes (Figure 1—figure supplement 3,
Supplementary file 1 - Tables 4 and 5).
Unsupervised hierarchical clustering analysis identified four distinct clusters of facial shape pheno-
types, for example many distances related to pronasale were clustered together (Figure 1—figure
Figure 1. Manhattan plot from meta-analysis discovery GWAS (N = 10,115 Europeans) for 78 Euclidean distances
between 13 facial landmarks. Results from meta-analysis of four GWASs in Europeans (N = 10,115), which were
separately conducted in RS, TwinsUK, ALSPAC, and PITT for 78 facial shape phenotypes that are displayed in a
signal ‘composite’ Manhattan plot at the bottom of the figure. All loci consisting of SNPs reaching study-wide
suggestive significance (p<5 � 10�8, red line) were nominated according to the nearby candidate genes in the
associated loci, and the top 10 loci were highlighted in colors. The black line indicates study-wide significance
after multiple trait correction (p<1.2�10�9). Novel and previously established face-associated genetic loci were
differentiated using colored and gray text, respectively. Annotation of the 13 facial landmarks used to derive the
78 facial phenotypes and the associated facial phenotypes are illustrated in the upper part of the figure.
The online version of this article includes the following figure supplement(s) for figure 1:
Figure supplement 1. An example of GPA, facial landmarks obtained from 3dMD images in 3193 participants
from the discovery cohorts RS.
Figure supplement 2. Phenotype characteristics of 78 facial traits.
Figure supplement 3. Phenotypic and genetic correlation matrix between all facial phenotypes in cohort RS.
Figure supplement 4. Quantile-Quantile plots and genomic inflation factors for 22 significant associated facial
traits.
Figure supplement 5. Power analysis.
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 4 of 32
Research article Genetics and Genomics
supplement 2D). Twin heritability of all facial phenotypes was estimated in TwinsUK as h2 mean(sd)
=0.52 (0.15), max = 0.86 and in Queensland Institute of Medical Research study (QIMR) as h2 mean
(sd)=0.55 (0.19), max = 0.91 (Supplementary file 1 - Table 6). The most heritable features were
linked to the central face (i.e., the outer- and inter- orbital distances, the nose breadth, and the dis-
tance between the subnasion and the inner eye corners; Figure 1—figure supplement 2E and F).
These twin-derived heritability estimates were generally higher than those obtained from genome-
wide SNPs in the same cohorts (Supplementary file 1 - Table 6). These results were overall consis-
tent with expectations and suggest that the phenotype correlation within the human face may be
explained in part by sets of shared genetic components.
GWASs and replicationsWe conducted a series of GWASs and meta-analyses to test the genetic association of 7,029,494
autosomal SNPs with 78 face phenotypes in RS, TwinsUK, ALSPAC, and PITT, totaling 10,115 sub-
jects of European descent, used as the discovery dataset. Inflation factors were in an acceptable
range in all meta-analyses (average l = 1.015, sd = 0.006; Figure 1—figure supplement 4), and
were thus not further considered. A matrix spectral decomposition analysis estimated the effective
number of independent facial traits as 43, which corresponds to a Bonferroni corrected study-wide
significant threshold of 1.2 � 10�9. A power analysis showed that under this threshold, our discovery
data had over 90% power to detect an allelic effect explaining 0.54% variance for individual pheno-
types (Figure 1—figure supplement 5A). In the discovery GWAS meta-analysis, a total of 221 SNPs
from six distinct loci showed study-wide significant association (p<1.2 � 10�9) with facial pheno-
types, among which two have not been previously reported: 4q28.1 INTU (top SNP rs1250495
p=3.03 � 10�10), and 12q24.21 TBX3 (rs1863716 p=1.47 � 10�10). The other four have been
described in previous GWASs of facial variation, including 2q36.1 PAX3, 4q31.3 SFRP2, 17q24.3
CASC17, and 20p11.22 PAX1 (Figure 1 and Supplementary file 1 - Table 7) (Liu et al., 2012;
Paternoster et al., 2012; Adhikari et al., 2016; Shaffer et al., 2016; Claes et al., 2018). Consider-
ing the traditional genome-wide significant threshold of 5 � 10�8 as our study-wide suggestive sig-
nificance threshold for replication studies, the power analysis showed that under this threshold, our
discovery data had over 90% power to detect an allelic effect explaining 0.43% variance for individ-
ual phenotypes (Figure 1—figure supplement 5B). In addition to the study-wide significant ones,
273 SNPs from 18 distinct loci passed the 5 � 10�8 threshold (Supplementary file 1 - Table 7), of
which 15 were novel and 3 (1p12 TBX15, 9q22.31 ROR2 and 17q24.3 SOX9) have been reported in
previous studies (Cha et al., 2018; Claes et al., 2018; Pickrell et al., 2016). Thus, in total, we identi-
fied 24 face-associated genetic loci, of which 17 were not reported in previous face GWASs, that we
followed-up via a multi-ethnic replication analysis (see below). In general, no significant heterogene-
ity was observed for the 24 top SNPs of the study-wide significant and suggestive associated loci,
that is only one SNP (rs3403289 at 2q36.1 PAX3) showed nominally significant (Cochran’s Q test
p=0.04, Table 1) heterogeneity between the discovery cohorts, but was not significant after multiple
testing correction.
The association signals at the 24 genetic loci involved multiple facial phenotypes clustered to the
central region of the face above the upper lip (Figure 1), and closely resembled the twins-based
face heritability map (Figure 1—figure supplement 2E and F). All seven previously reported loci
showed largely consistent allele effects on the same or similar sets of facial phenotypes as described
in previous GWASs (Supplementary file 1 - Table 8). Four (2q36.1 PAX3, 9q22.31 ROR2, 17q24.3
CASC17, and 20p11.22 PAX1) out of the 24 face-associated loci have been noted in the GWAS cata-
log for face morphology or related phenotypes that is nose size, chin dimples, monobrow thickness,
and male pattern baldness (Supplementary file 1 - Table 9). Five out of the 24 loci showed
genome-wide significant association (p<5e-8) with non-facial phenotypes and/or diseases in the
GeneATLAS database (Canela-Xandri et al., 2018) (Supplementary file 1 - Table 10), suggesting
pleiotropic effects. Six out of the 24 loci showed a high degree of diversity among the major conti-
nental groups in terms of both allele frequency differences (>0.2) and Fst values (empirical p<0.05),
including 1p31.2 RPE65, 2q36.1 PAX3, 4q28.1 INTU, 16q12.1 SALL1, 16q12.2 RPGRIP1L and
17q24.3 CASC17 (Supplementary file 1 - Tables 11 and 12). Three out of the 24 face-associated
loci showed signals of positive selection in terms of the integrated haplotype scores (iHS, empirical
p<0.01), including RPE65, RPGRIP1L and CASC17 (Supplementary file 1 - Table 12). None of the
24 loci overlapped with the previously reported signals of singleton density score (SDS, empirical
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 5 of 32
Research article Genetics and Genomics
p<0.01) in Europeans (Field et al., 2016), which may indicate that the observed selection signals are
unlikely the consequences from the recent selective pressures detectable via SDS analysis.
We selected the 24 top-associated SNPs (Table 1), one SNP per for each of the identified 24
genetic loci passing the study-wide suggestive significance threshold (p<5�10�8), for replication
studies in a total of 7917 multi-ethnic subjects from three additional cohorts that is the Consortium
for the Analysis of the Diversity and Evolution of Latin America (CANDELA) study involving Latin
Americans known to be of admixed Native American and European ancestry, the Xinjiang Uyghur
(UYG) study from China known to be of admixed East Asian and European ancestry, and the
Queensland Institute of Medical Research (QIMR) study from Australia involving Europeans. We
used a ‘combined test of dependent tests’ (Kost and McDermott, 2002) to account for the incom-
patibility among facial traits from the three replication cohorts, which tests for H0: no association for
all facial phenotypes in all replication cohorts vs. H1: associated with at least one facial phenotypes
Table 1. SNPs significantly associated (p<5�10�8) with facial shape phenotypes from European discovery GWAS meta-analysis (RS,
TwinksUK, ALSPAC, and PITT), and their multi-ethnic replication (UYG, CANDELA and QIMR).
Discovery meta-analysis Replication
(N = 10,115) (N = 7,917)
Region SNP Nearest Gene EA OA Trait Beta P Q Com. P
Novel face-associated loci
1p36.22 rs143353512 CASZ1 A G Prn-AlL �0.29 6.44 � 10�9 0.73 0.0001
1p36.13 rs200243292 ARHGEF19 I T EnR-ChL �0.11 1.46 � 10�8 0.54 0.0640
1p31.2 rs77142479 RPE65 C A EnL-Sn �0.08 7.65 � 10�9 0.90 0.0121
2p12 rs10202675 LRRTM4 T C EnR-AlR �0.26 4.43 � 10�8 0.40 0.0226
2q31.1 rs2884836 KIAA1715 T C ExR-ChR �0.09 3.04 � 10�8 0.52 0.1096
3q12.1 rs113663609 CMSS1 A G EnR-ChR �0.12 3.46 � 10�8 0.96 0.0782
4q28.1 rs12504954 INTU A G Prn-AlL �0.09 3.03 � 10�10 0.52 0.0015
6p22.3 rs2225718 RNF144B C T EnR-AlR �0.09 2.97 � 10�8 0.60 0.0071
6p21.2 rs7738892 KIF6 T C EnR-N 0.11 1.34 � 10�8 0.09 0.0018
8p23.2 rs1700048 CSMD1 C A ExR-ChL �0.22 3.94 � 10�8 0.73 0.1131
8q21.3 rs9642796 DCAF4L2 A G AlL-Ls �0.11 4.52 � 10�8 0.07 0.3090
10q22.1 rs201719697 SUPV3L1 A D ExL-AlL �0.28 3.42 � 10�8 0.66 NA
12q24.21 rs1863716 TBX3 A C Prn-AlR �0.09 1.47 � 10�10 0.53 2.45 � 10�5
13q14.3 rs7325564 LINC00371 T C N-Prn 0.09 1.34 � 10�8 0.16 0.3519
14q32.2 rs1989285 C14orf64 G C N-Prn �0.10 4.54 � 10�8 0.82 0.0019
16q12.1 rs16949899 SALL1 T G ExR-ChL �0.13 3.35 � 10�8 0.76 0.8912
16q12.2 rs7404301 RPGRIP1L G A AlL-Ls �0.09 3.49 � 10�9 0.43 2.87 � 10�7
Previously reported face-associated loci
1p12 rs1229119 TBX15 T C ExR-ChR 0.08 2.25 � 10�8 0.26 0.1219
2q36.1 rs34032897 PAX3 G A EnR-N 0.14 1.96 � 10�17 0.04 0.0020
4q31.3 rs6535972 SFRP2 C G EnL-AlL 0.12 3.51 � 10�12 0.12 5.89 � 10�12
9q22.31 rs2230578 ROR2 C T EnL-Sn 0.09 9.02 � 10�9 0.66 1.09 � 10�6
17q24.3 rs8077906 CASC17 A G Prn-EnL �0.09 3.00 � 10�11 0.24 0.0505
17q24.3 rs35473710 SOX9 G A AlR-ChL 0.19 3.95 � 10�8 0.37 0.2634
20p11.22 rs4813454 PAX1 T C AlL-AlR �0.10 2.32 � 10�11 0.58 0.0002
Except rs2230578 (3’-UTR of ROR2) and rs7738892 (a synonymous variant of KIF6), all SNPs are intronic or intergenic. Gene symbols in bold indicate suc-
cessful replication after Bonferroni correction of 24 loci (p<2.1�10�3). Meta P in bold indicates study-wide significance in the discovery analysis after multi-
ple trait correction (p<1.2�10�9). Replication P in bold means significant after Bonferroni correction for multiple tests (p<2.1�10�3). Q: p-value from the
Cochran’s Q test for testing heterogeneity between discovery cohorts. EA and OA, the effect allele and the another allele. Com. P: p-values from a com-
bined test of dependent tests. NA, not available.
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Research article Genetics and Genomics
in at least one replication cohorts. After Bonferroni correction of multiple testing of 24 SNPs, signifi-
cant evidence of replication (p<2.1�10�3) was obtained for 10 SNPs, among which six were novel
loci: 1p36.22 CASZ1, 4q28.1 INTU, 6p21.2 KIF6, 12q24.21 TBX3, 14q32.2 C14orf64, and 16q12.2
RPGRIP1L (Figure 2), and four have been described in previous face GWASs: 2q36.1 PAX3, 4q31.3
SFRP2, 9q22.31 ROR2, and 20p11.22 PAX1 (Adhikari et al., 2016; Claes et al., 2018;
Paternoster et al., 2012; Pickrell et al., 2016; Shaffer et al., 2016).
The allelic effects of the replicated SNPs were highly consistent across all participating cohorts,
while the individual cohorts were underpowered (Figure 2—figure supplements 1–6), further
emphasizing on the merit of our collaborative study. The associated phenotypes of the replicated
SNPs demonstrated a clear pattern of facial symmetry that is the same association was observed on
both sides of the face, while such a symmetric pattern was less clear for most phenotypes involved
in the non-replicated loci (Figure 2—figure supplements 7–17). Several novel replicated loci
showed effects on the similar sets of facial shape phenotypes; for example, 1p36.22 CASZ1 and
4q28.1 INTU (Figure 2A and C) both affected the distances between pronasion and alares. More-
over, several novel replicated loci affected phenotypes in multiple facial regions for example 4q32.1
C14orf64 and 12q24.1 TBX3 (Figure 2D and E) both affected many distances among eyes, alares
and mouth. It should be noted however, that the discovery dataset is of European ancestry while the
replication dataset is multi-ethnic and the facial phenotypes could not be obtained in the same way
as in the discovery set; hence, the replication results were rather conservative, that is the possibility
of false negatives in this replication study cannot be excluded. This was evident from the results of
the replication attempts of the seven known loci (1p12 TBX15, 2q36.1 PAX3, 4q31.3 SFRP2, 9q22.31
ROR2, 17q24.3 CASC17, 17q24.3 SOX9, 20p11.22 PAX1) (Figure 2—figure supplements 18–
24). Out of these 7, only four were replicated (PAX3, SFRP2, ROR2 and PAX1, Table 1). For this rea-
son, we considered all of the 494 SNPs from the 24 loci passing the study-wide suggestive threshold
in the subsequent polygenic score analyses and in the functional annotation analyses.
Integration with previous literature knowledgeIn our discovery GWAS dataset, we also investigated 122 face-associated SNPs reported in previ-
ously published facial GWASs (Adhikari et al., 2016; Cha et al., 2018; Claes et al., 2018;
Cole et al., 2016; Lee et al., 2017; Liu et al., 2012; Paternoster et al., 2012; Pickrell et al., 2016;
Shaffer et al., 2016). Out of those, a total of 44 (36%) SNPs showed significant association on either
the same set of facial phenotypes or at least one facial phenotypes in a combined test, after Bonfer-
roni correction for the number of SNPs (adjusted p<0.05) (Supplementary file 1 - Table 8). Notably,
none of the 5 SNPs reported in a previous African GWAS (Cole et al., 2016) was replicated in our
European dataset. This is unlikely explained by the allele frequency differences between Sub-
Saharan African (AFR) and Europeans (EUR) (absolute frequency differences between AFR and EUR
were less than 0.1 in the 1000 Genomes project) but more likely due to different phenotypes, that is
in the previous study these loci were primarily associated with facial size, which was not tested on
our study.
We also investigated the potential links between facial phenotypes and 60 SNPs in 38 loci previ-
ously implicated in non-syndromic cleft lip and palate (NSCL/P) phenotype, which is linked with nor-
mal variation of facial morphology as suggested previously (Beaty et al., 2010; Beaty et al., 2011;
Birnbaum et al., 2009; Grant et al., 2009; Leslie et al., 2017; Ludwig et al., 2017; Ludwig et al.,
2012; Mangold et al., 2010; Sun et al., 2015; Yu et al., 2017). Among these, 17 SNPs in 13 loci
showed significant face-associations in the discovery cohorts after Bonferroni correction for the num-
ber of SNPs and phenotypes, and many (11 SNPs in eight loci) involving cleft related facial landmarks
as expected, for example subnasale, labliale superius, and labiale inferius (Supplementary file 1 -
Table 13).
Multivariable model fitting and polygenic face scoresIn the RS cohort, a multiple-regression conditioning on the effects of the 24 lead SNPs identified 31
SNPs showing significant (adjusted p<0.05) independent effects on sex- and age-adjusted face phe-
notypes (Supplementary file 1 - Table 14). These 31 SNPs individually explain less than 1%, and
together explain up to 4.62%, of the variance for individual phenotypes (Figure 3A and B). The top-
explained phenotypes clustered to the central region of the face, that is the distances between
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Figure 2. Six novel genetic loci associated with facial shape phenotypes and successfully replicated. The figure is
composed by six parts, (A) 1p36.22 CASZ1 region, (B) 4q28.1 INTU region, (C) 6p21.2 KIF6 region, (D) 12q24.21
TBX3 region, (E) 14q32.2 C14orf64 region, and (F) 16q12.2 RPGRIP1L region. Each part includes two figures, Face
map (left) denoting all of the top-SNP-associated phenotypes weighted by the statistical significance (-log10P). The
dashed line means that the P value was nominally significant (p<0.01) but did not reach study-wide suggestive
significance (p>5e-8). LocusZoom (right) shows regional association plots for the top-associated facial phenotypes
with candidate genes aligned below according to the chromosomal positions (GRCh37.p13) followed by linkage
disequilibrium (LD) patterns (r2) of EUR in the corresponding regions. Similar figures for all 24 study-wide
suggestively significant loci are provided in Figure 2—figure supplements 1–24.
The online version of this article includes the following figure supplement(s) for figure 2:
Figure supplement 1. Overviews of association, selection, LD and regulation patterns in 24 associated regions.
Figure supplement 2. Association, selection, LD and regulation patterns for rs12504954 located around INTU.
Figure supplement 3. Association, selection, LD and regulation patterns for rs7738892 located around KIF6.
Figure supplement 4. Association, selection, LD and regulation patterns for rs1863716 located around TBX3.
Figure supplement 5. Association, selection, LD and regulation patterns for rs1989285 located around C14orf64.
Figure supplement 6. Association, selection, LD and regulation patterns for rs7404301 located around RPGRIP1L.
Figure supplement 7. Association, selection, LD and regulation patterns for rs200243292 located around
ARHGEF19.
Figure supplement 8. Association, selection, LD and regulation patterns for rs77142479 located around RPE65.
Figure supplement 9. Association, selection, LD and regulation patterns for rs10202675 located around LRRTM4.
Figure supplement 10. Association, selection, LD and regulation patterns for rs2884836 located around
KIAA1715.
Figure supplement 11. Association, selection, LD and regulation patterns for rs113663609 located around
CMSS1.
Figure supplement 12. Association, selection, LD and regulation patterns for rs2225718 located around RNF144B.
Figure supplement 13. Association, selection, LD and regulation patterns for rs1700048 located around CSMD1.
Figure supplement 14. Association, selection, LD and regulation patterns for rs9642796 located around
DCAF4L2.
Figure supplement 15. Association, selection, LD and regulation patterns for rs201719697 located around
SUPV3L1.
Figure 2 continued on next page
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nasion, subnasale, pronasale, left endocanthion and right endocanthion. The variance explained was
potentially overestimated in RS cohort since the SNP selection and model building were conducted
using the same dataset. However, potential overfitting is unexpected to have a drastic effect, given
Figure 2 continued
Figure supplement 16. Association, selection, LD and regulation patterns for rs7325564 located around
LINC00371.
Figure supplement 17. Association, selection, LD and regulation patterns for rs16949899 located around SALL1.
Figure supplement 18. Association, selection, LD and regulation patterns for rs1229119 located around TBX15.
Figure supplement 19. Association, selection, LD and regulation patterns for rs34032897 located around PAX3.
Figure supplement 20. Association, selection, LD and regulation patterns for rs6535972 located around SFRP2.
Figure supplement 21. Association, selection, LD and regulation patterns for rs2230578 located around ROR2.
Figure supplement 22. Association, selection, LD and regulation patterns for rs8077906 located around CASC17.
Figure supplement 23. Association, selection, LD and regulation patterns for rs35473710 located around SOX9.
Figure supplement 24. Association, selection, LD and regulation patterns for rs4813454 located around PAX1.
Figure 3. Polygenic scores of 78 facial phenotypes. (A) Facial phenotype variance is explained by a multivariable
model consisting of 31 face-associated SNPs with independent effects. (B) Unsupervised clustering reveals the
details on the explained phenotype variance, where the SNPs were attributed to the candidate genes in the
associated regions. All phenotypes with the total explained variance > 2% are shown. SNPs were colored
according to their raw p-values and those passing FDR < 0.05 were indicated in squares. (C) Mean standardized
polygenic scores calculated by applying the multivariable model trained in the RS discovery sample to Sub-
Saharan Africans (AFR), East Asians (EAS) and Europeans (EUR) in the 1000 Genomes Project data. (D) Examples of
the distributions of the face scores in samples of different ancestry origin/country.
The online version of this article includes the following figure supplement(s) for figure 3:
Figure supplement 1. Effects of NSCL/P-associated SNPs to 78 facial phenotypes.
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that some of the selected SNPs showed weaker effects in RS than in other cohorts used
(Supplementary file 1 - Table 7). We then used the fitted models to derive a set of polygenetic face
scores for EUR, AFR and East Asian (EAS) subjects (total N = 1,668) from the 1000-Genomes Project.
The polygenic face scores based on the 31 SNPs were largely reversely distributed between EUR
and AFR, with EAS situated in between (Figure 3C). EUR showed the longest distances among the
vertical phenotypes, while AFR had the widest of the horizontal phenotypes. EAS was consistently
in-between with the most differential phenotype scores observed for nose wing breadth (AFR > EAS
> EUR) and the nose length (EUR > EAS > AFR). An exception was for mouth phenotypes, where
AFR had the largest values in both mouth width and lip thickness (Figure 3D). The nose-related
score distribution, for example nose breadth and length, thus largely assembled the facial features
in major continental groups, consistent with the hypotheses regarding adaptive evolution of human
facial morphology (Noback et al., 2011; Weiner, 1954), for example nose width and nose length
have been found to correlate with temperature and humidity. It should be noted, however, that the
possibility of potential bias cannot be excluded due to the fact that the discovery GWAS was con-
ducted in only Europeans. Notably, the polygenic scores of the NSCL/P-associated SNPs explained
up to 1.2% of the age- and sex- adjusted phenotypic variance for phenotypes mostly between nose
and mouth, for example right alare – right cheilion and pronasale – right cheilion (Figure 3—figure
supplement 1).
Gene ontology of face-associated genetic lociA gene ontology enrichment analysis for the 24 face-associated genetic loci (Table 1) highlighted a
total of 67 biological process terms and seven molecular function terms significantly enriched with
different genes group (FDR < 0.01 or q value < 0.01, Supplementary file 1 - Table 15), with the top
significant terms being ‘embryonic digit morphogenesis’ and ‘embryonic appendage morphogene-
sis’ (FDR < 1 � 10�8, Figure 4—figure supplement 1). Biological process terms were categorized in
four broader categories, ‘morphogenesis’, ‘differentiation’, ‘development’ and ‘regulation’. These
results underlined the important role of embryonic developmental and regulatory processes in shap-
ing human facial morphology. Furthermore, cis-eQTL effects of the 494 face-associated SNPs at the
24 loci (Supplementary file 1 - Table 7) were investigated using the GTEx data. Significant multi-tis-
sue cis-eQTL effects (adjusted p<0.05) were found around three genes, ARHGEF19, RPE65, and
TBX15 (Supplementary file 1 - Table 16). No significant tissue-specific eQTL effects were observed,
likely due to the lack of cell types indexed within the GTEx database that are directly involved in cra-
niofacial morphology.
Expression of face-associated genetic loci in embryonic cranial neuralcrest cellsEmbryonic cranial neural crest cells (CNCCs) arise during weeks 3–6 of human gestation from the
dorsal part of the neural tube ectoderm and migrate into the branchial arches. They later form the
embryonic face, consequently establishing the central plan of facial morphology and determining
species-specific and individual facial variation (Bronner and LeDouarin, 2012; Cordero et al.,
2011). Recently, CNCCs have been successfully derived in-vitro from human embryonic stem cells or
induced pluripotent stem cells (Prescott et al., 2015). Taking advantage of the available CNCC
RNA-seq data (Prescott et al., 2015) and other public RNA-seq datasets compiled from GTEx
(Lonsdale et al., 2013) and ENCODE (ENCODE Project Consortium, 2012), we compared 24
genes, which were nearest to the top-associated SNPs at the 24 face-associated genetic loci identi-
fied in our discovery GWAS meta-analysis, with the background genes over the genome for their
expression in CNCCs and 49 other cell types. In 89% of 9 embryonic stem cells, 65% of 20 different
tissue cells, and 15% of 20 primary cells these 24 genes showed significantly higher expression in all
cell types (p<0.05) after multiple testing correction compared to the background genes (Figure 4A),
and the most significant difference was observed in CNCCs (p=3.8 � 10�6). Furthermore, these 24
genes also showed preferential expression in CNCCs compared to their expression in other cell
types, that is in 65% of 20 different tissue cells, in 60% of 20 primary cells, and in 22% of 9 embry-
onic stem cells (Figure 4A). Specifically, 16 (66.7%) of these 24 genes showed preferential expres-
sion in CNCCs compared to 49 other cell types. The top-ranked three preferentially expressed
genes were PAX3 (p=1.3 � 10�29), INTU (p=8.3 � 10�25), and ROR2 (p=4.5 � 10�23, Figure 4B).
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Research article Genetics and Genomics
Figure 4. Expression of 24 genes located at the identified 24 face-associated genetic loci in 50 cell types.
Expression levels of the genes nearest to the 24 top-associated SNPs (see Table 1) in 50 cell types were displayed
in boxplots based on published data from the study of Prescott et al. (2015), the GTEx
database (Lonsdale et al., 2013) and the ENCODE database (ENCODE Project Consortium, 2012). The cell
types included CNCC, 20 other tissue cells, 20 primary cells and nine embryonic stem cells. (A) Boxplots of
normalized RNA-seq VST values for the 24 genes (in orange) and all genome background genes (~50,000 genes, in
blue). Expression difference between the genome background genes and the 24 genes was tested in each cell
type using the unpaired Wilcoxon rank-sum test. Distribution of the expression levels in CNCC showed smaller
variation than those of several embryonic stem cells which showed higher median. The expression of the 24 genes
in CNCCs was also iteratively compared with that in other cell types using paired Wilcoxon rank-sum test.
Statistical significance was indicated: *p<0.05 after multiple correcting test of cell lines amount. (B) Difference
significance of normalized RNA-seq VST values in each of 24 genes were displayed using barplots between
CNCCs and all 49 types of cells (purple), CNCCs and 20 tissue cells (blue), CNCCs and 20 primary cells (green),
CNCCs and nine embryonic stem cells (orange). The difference between the value of CNCCs and other cell type
Figure 4 continued on next page
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Furthermore, some mid-preferentially expressed genes like DCAF4L2 and non-preferentially
expressed genes like RPE65 became top-ranked preferentially expressed genes when testing sub-
groups of cell types (Figure 4B). Although not necessarily is the nearest gene the causative gene
and not necessarily is there only one causative gene per locus, the observation of significant prefer-
ential expression of the nearby genes considered in this analysis does support the hypothesis that
variation of facial shape may indeed originate during early embryogenesis (Claes et al., 2018), and
provide a priority list in different stages of cell differentiation with genes likely involved in embryo
ectoderm derived phenotypes such as facial variation for future in-vivo functional studies.
Cis-regulatory signals in face-associated genetic lociIt is becoming increasingly clear that cis-regulatory changes play a central role in determining human
complex phenotypes (Carroll, 2008; Wray, 2007). In our study, apart from those at KIF6 and ROR2,
all identified face-associated DNA variants were non-exonic. With preferential expression pattern
validated in CNCCs, we explored the potential cis-regulatory activity of the face-associated DNA
variants using the CNCC epigenomic mapping datasets (Prescott et al., 2015). This includes ChIP-
seq data on transcription factor (TFAP2A and NR2F1) binding, general coactivator (p300) binding, or
histone modifications associated with active regulatory elements (H3K4me1, H3K4me3, and
H3K27ac), as well as ATAC-seq data on chromatin accessibility. Abundant entries of cis-regulatory
signals were detected surrounding the face-associated loci. In particular, 6 (25%) of the 24 face-asso-
ciated loci, that is 1p36.13 ARHGEF19, 2q36.1 PAX3, CMSS1, 4q28.1 INTU, 16q12.1 SALL1, and
16q12.2 RPGRIP1L, showed significant enrichment of cis-regulatory entries at the top 0.1% of the
genome level in at least one epigenomic tracks after Bonferroni correction (adjusted p<0.05, Fig-
ure 5—figure supplement 1). We selected 5 SNPs as candidate regulatory SNPs (Figure 5A and B,
Supplementary file 1 - Table 17) as they not only overlapped with the putative enhancers defined in
CNCCs (Prescott et al., 2015) and penis foreskin melanocyte primary cells (Chadwick, 2012;
ENCODE Project Consortium, 2012), but also showed high LD (r2 > 0.7) with at least one of the
face-associated SNPs at the study-wide suggestive significance level. These five candidate regulatory
SNPs were further studied via functional experiments as described in the following section.
Confirmation of cis-regulatory enhancer effects in neural crestprogenitor cellsWe performed in-vitro luciferase reporter assays to quantify the potential regulatory effect of the
five face-associated SNPs suggested by the in-silico analyses outlined above as regulatory candi-
dates that is rs13410020 and rs2855266 from the 2q36.1 PAX3 region, rs17210317 and rs6828035
from the 4q28.1 INTU region, and rs4783818 from the 16q12.2 RPGRIP1L region
(Supplementary file 1 - Table 17). Luciferase reporter assays in CD271+ neural crest progenitor cells
demonstrated that both SNPs in 2q36.1 and 4q28.1, respectively, showed statistically significant
allele-specific effects on enhancer activity (Figure 5C). In the 4q28.1 region, the derived SNP alleles
were associated with decreased luciferase expression (33.5 �~ 10.4 � , Supplementary file 1 - Table
18) as well as a reduced length of some nose features (�0.087 < beta < �0.078, Supplementary file
1 - Table 7). In the 2q36.1 region, the derived SNP alleles were associated with increased luciferase
expression (1.5 �~ 3.7 � , Supplementary file 1 - Table 18) as well as an increased length of some
nasion-related features (0.131 < beta < 0.149, Supplementary file 1 - Table 7). Using a luciferase
assay for rs4783818 from the 16q12.2 region in CD271+ neural crest progenitor cells, we obtained
an allele-specific effect on enhancer activity, although it was not statistically significant (Figure 5C).
Additional luciferase reporter assays using G361 melanoma cells provided similar results, indicating
that the regulatory activity associated with the DNA variants is conserved across the neural crest cell
Figure 4 continued
groups was tested using the one-sample Student’s t test. Dotted line represents Bonferroni corrected significant
threshold (p<0.0021). Significant gene labels were in color compared to non-significant gene labels in black.
The online version of this article includes the following figure supplement(s) for figure 4:
Figure supplement 1. Gene ontology enrichment analysis for 24 face-associated genes.
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Research article Genetics and Genomics
lineage (Supplementary file 1 - Table 18). These results provide evidence that the tested face-asso-
ciated SNPs impact the activity of enhancer elements and thus have regulatory function.
DiscussionThis study represents the largest genome scan to date examining facial shape phenotypes in humans
quantified from 3D facial images. We identified 24 genetic loci showing study-wide suggestive asso-
ciation with normal-range facial shape phenotypes in Europeans, including 17 novel ones, of which
10 were successfully replicated in additional multi-ethnic population cohorts including six novel loci.
Significant gene enrichment in morphogenesis related pathways and cis-regulation signals with pref-
erential CNCC expression activities were observed at these genetic loci, underlining their involve-
ment in facial morphology. Our findings were additionally supported by a strong integration with
Figure 5. Three examples of genetic loci associated with facial shape phenotypes. Three examples of facial shape
associated loci we discovered are depicted in details, including two novel loci (INTU; RPGRIP1L) and one (PAX3)
that overlaps with previous face GWAS findings. The figure is composed by three layers (A–C) organized from the
top to the bottom. (A) Denotes the linkage disequilibrium (LD) patterns (r2) of EUR in the corresponding regions
and epigenetic annotation of CNCC’s regulatory elements in corresponding regions using WashU Epigenome
Browser. Chip-seq profiles display histone modifications associated with active enhancers (H3K27ac, H3K4me1) or
promoters (H3K4me3), and binding of general coactivator p300 and transcription factor TFAP2A. The ATAC-seq
track shows chromatin accessibility. The PhyloP track indicates cross-species conservation. (B) SNPs in LD
(r2 > 0.25) with the top-associated SNP and all base-pairs in vicinity (within 20 kb, p<0.05) are displayed according
to their log scaled quantile rank (-log10p, axis scale) in the circular figure, where the rank is calculated using the
Chip-seq values in the whole genome. In addition, SNPs associated with facial phenotypes in our meta-analysis of
GWASs were highlighted according to their association p values (PMeta, color scale) and their LD (r2) with the top-
associated SNP in the region (points size). (C) Shows results of luciferase reporter assays in CD271+ neural crest
progenitor cells by which we tested allele-specific enhancer activity of putative enhancers surrounding the
selected SNPs using the Student´s t-test. Data are presented as relative luciferase activity (firefly/renilla activity
ratio) fold change compared to the construct containing less active allele. Similar figures for layers A and B are
provided for all face associated loci in Figure 2—figure supplements 1–24.
The online version of this article includes the following figure supplement(s) for figure 5:
Figure supplement 1. Overview of regulation activity of 24 face-associated loci in CNCCs.
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Research article Genetics and Genomics
previous genetic association and functional studies. Moreover, via in-vitro cell culture experiments,
we functionally exemplified the regulatory activity of selected face-associated SNPs at two newly
identified (INTU and RPGRIP1L) and one established (PAX3) face shape genes.
The six replicated novel face-associated loci included 1p36.22 CASZ1 4q28.1 INTU 6p21.2 KIF6,
12q24.21 TBX3, 14q32.2 C14orf64, and 16q12.2 RPGRIP1L. For 4q28.1 INTU and 16q12.2
RPGRIP1L, we demonstrated an impact of selected DNA variants on enhancer activity. INTU, also
known as planar cell polarity (PCP) effector, has been reported to compromise proteolytic process-
ing of Gli3 by regulating Hh signal transduction (Zeng et al., 2010). Notably, SNPs in the GLI3
region have been previously associated with human nose wing breadth (Adhikari et al., 2016), sup-
porting a link between INTU and facial morphogenesis. In addition, rare frameshift mutations in
INTU have been found to cause human Oral-Facial-Digital (OFD) syndromes as characterized by
abnormalities of the face and oral cavity (Bruel et al., 2017). A previous study found that Rpgrip1l
mutant mouse embryos displayed facial abnormalities in cleft upper lips and hypoplastic lower jaws
(Delous et al., 2007). FTO, a proximate gene to RPGRIP1L, has also been found essential for normal
bone growth and bone mineralization in mice (Sachse et al., 2018). TBX3, a member of the T-box
gene family, causes Ulnar-mammary syndrome which is a rare disorder characterized by distinct chin
and nose shape together with many other abnormal morphological changes (Bamshad et al., 1997;
Joss et al., 2011). Intriguingly, TBX3 and TBX15 associated facial phenotypes showed an asymmetric
pattern, particularly for nose phenotypes (TBX3) and eye-mouth distances (TBX15). These two genes
are thus good candidates for further studying the genetic basis of facial asymmetry and related dis-
orders. A synonymous variant (rs7738892) in the transcript coding region of KIF6 was associated
with facial traits. It has been shown that the homologous Kif6 transcript sequence was necessary for
spine development in zebrafish, likely due to its role in cilia, which is known to utilize neural crest
cells for regulating ventral forebrain morphogenesis (Buchan et al., 2014). For the remaining two
novel loci (CASZ1 and C14orf64), there is current lack of existing literature evidence supporting their
involvement in facial variation.
The four replicated previously reported face-associated loci included 2q36.1 PAX3, 4q31.3
SFRP2, 9q22.31 ROR2, and 20p11.22 PAX1. Their effects observed in the current study were all con-
sistent with the previous findings, for example PAX3 was associated with position of the nasion
(Liu et al., 2012; Paternoster et al., 2012), SFRP2 with distance between inner eye corners and
alares (Adhikari et al., 2016; Claes et al., 2018), PAX1 with nose wing breadth (Adhikari et al.,
2016; Shaffer et al., 2016), and ROR2 with nose size (Pickrell et al., 2016). The face-associated
rs2230578 at 9q22.31 is in the 3’-UTR of ROR2. A Ror2 knockout mouse has been used as a model
for the developmental pathology of autosomal recessive Robinow syndrome, a human dwarfism syn-
drome characterized by limb shortening, vertebral and craniofacial malformations, and small external
genitalia (Schwabe et al., 2004). Among the 11 non-replicated novel loci, two are worth mentioning:
KIAA1715 maps to about 100kbp upstream of the HOXD cluster (homeobox D cluster), which has
been highlighted by two independent facial variation GWAS (Claes et al., 2018; Pickrell et al.,
2016). DCAF4L2 gene variants were previously associated with NSCL/P (Leslie et al., 2017;
Ludwig et al., 2012; Yu et al., 2017) and we revealed a significant effect on the distance between
alares and the upper-lip. We therefore regard it as likely that true positive findings exist among the
11 non-replicated novel loci. This is further supported by our finding that among the total of 14 non-
replicated loci, three loci (21%) that is TBX15 (Claes et al., 2018; Pickrell et al., 2016), CASZ17
(Claes et al., 2018; Pickrell et al., 2016), and SOX9 (Cha et al., 2018; Claes et al., 2018;
Pickrell et al., 2016) correspond to previously identified face-associated loci. As such, their re-iden-
tification in our discovery GWAS meta-analysis represents a confirmation per se, even without signifi-
cant evidence from our replication analysis. Moreover, pleiotropic effects of TBX15 on skeleton,
for example stature, were previously demonstrated by a large-sized GWAS (Wood et al., 2014).
Loss of function of TBX15 in mice has been shown to cause abnormal skeletal development
(Singh et al., 2005). Thus, the fact that these three previously reported face-associated loci were
identified in our discovery GWAS, but were not confirmed in our replication analysis, likely is
explained by relatively low statistical power, especially for the European replication dataset
(N = 1,101) being most relevant here as these three genes were highlighted in Europeans in the pre-
vious and in our study. Moreover, for the European QIMR samples in the replication set, no direct
replication analysis was possible due to the availability of 2D images, but not 3D images as in the
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Research article Genetics and Genomics
discovery dataset. Therefore, future studies shall further investigate these 11 novel face-associated
loci.
Of the previously identified face-associated genetic loci, several candidate genes for example
Pax3 (Zalc et al., 2015), Prdm16 (Bjork et al., 2010), Tp63 (Thomason et al., 2008), Sfrp2
(Satoh et al., 2008), and Gli3 (Hui and Joyner, 1993) have been shown to play important roles in
cranial development of embryonic mice. Moreover, in adult mice only Edar has been investigated for
its effect on normal facial variation (Adhikari et al., 2016), but the respective face-associated mis-
sense EDARV370A is nearly absent in Europeans (Kamberov et al., 2013). Here we showed via
direct experimental evidence in neural crest cells that face-associated SNPs in INTU, PAX3, and
RPGRIP1L are likely involved in enhancer functions and regulate gene activities. Future studies shall
demonstrate functional evidence for more SNPs and genes identified here or previously to be signifi-
cantly association with facial shape phenotypes. As demonstrated here, this shall go beyond evi-
dence on the bioinformatics level (Claes et al., 2018) and shall involve direct functional testing of
the associated DNA variants in suitable cell lines or mouse models.
Our results indirectly support the hypothesis that the facial differentiation observed among world-
wide human populations is shaped by positive selection. For some facial features, it is reasonable to
speculate a primary selective pressure on the morphological effects of the associated variants,
although many of these variants may have pleiotropic effects on other fitness-related phenotypes.
For example, nasal shape, which is essential for humidifying and warming the air before it reaches
the sensitive lungs, has been found to significantly correlate with climatic variables such as tempera-
ture and humidity in human populations (Noback et al., 2011). Notably, many of the SNPs
highlighted in our study are involved in nasal phenotypes. The overall effect of these SNPs as mea-
sured by polygenic scores largely assembled the nasal shape differences among major continental
groups, which implies that human facial variation in part is caused by genetic components that are
shared between major human populations. However, there are existing examples of population-spe-
cific effects, for example, EDAR clearly demonstrates an Asian specific effect, which impacts on vari-
ous ectoderm-derived appearance traits such as hair morphology, size of the breast, facial shape in
Asians (Adhikari et al., 2015; Kamberov et al., 2013; Kimura et al., 2009; Tan et al., 2013). The
respective face-associated missense DNA variant is rare in European and African populations, dem-
onstrating regional developments in Asia.
Nevertheless, the polygenic face scores only explained small proportions of the facial phenotype
variance with up to 4.6%. This implies that many more face-predictive genetic information remains
to be discovered in future studies, which - in case enough - may provide the prerequisite for practi-
cal applications of predicting human facial information from genomic data such as in forensics or
anthropology. On the other hand, the increasing capacity of revealing personal information from
genomic data may also have far-reaching ethical, societal and legal implications, which shall be
broadly discussed by the various stakeholders alongside the genomic and technological progress
made here and to be made in future studies.
In summary, this study identified multiple novel and confirmed several previously reported
genetic loci influencing facial shape variation in humans. Our findings extend knowledge on natural
selection having shaped the genetic differentiation underlying human facial variation. Moreover, we
demonstrated the functional effects of several face-associated genetic loci as well as face-associated
DNA variants with in-silico bioinformatics analyses and in-vitro cell line experiments. Overall, our
study strongly enhances genetic knowledge on human facial variation and provides candidates for
future in-vivo functional studies.
Materials and methods
Cohort detailsThe four discovery cohorts, totaling 10,115 individuals, were Rotterdam Study (RS, N = 3,193,
North-Western Europeans from the Netherlands), TwinsUK (N = 1,020, North-Western Europeans
from the UK), ALSPAC (N = 3,707, North-Western Europeans from the UK), and Pittsburgh 3D Facial
Norms study (PITT, N = 2,195, European ancestry from the United States). The three replication
cohorts, totaling 7917 individuals, were CANDELA Study (N = 5,958, Latin Americans with ancestry
admixture estimated at 48% European, 46% Native American and 6% African), Xinjiang Uyghur
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Research article Genetics and Genomics
Study (UYG, N = 858, Uyghurs from China with ancestry admixture estimated at 50% East Asian and
50% European), and Queensland Institute of Medical Research Study (QIMR, N = 1,101, North-West-
ern European ancestry from Australia). Three-dimensional facial surface images were acquired in all
discovery cohorts and UYG, while frontal 2-dimensional photographs were used in CANDELA and
QIMR.
Rotterdam Study (RS)The RS is a population based cohort study of 14,926 participants aged 45 years and older, living in
the same suburb of Rotterdam, the Netherlands (Hofman et al., 2013). The present study includes
3193 participants of Dutch European ancestry, for whom high-resolution 3dMDface digital photo-
graphs were taken. Genotyping was carried out using the Infinium II HumanHap 550K Genotyping
BeadChip version 3 (Illumina, San Diego, California USA). Collection and purification of DNA have
been described previously (Kayser et al., 2008). All SNPs were imputed using MACH software
(www.sph.umich.edu/csg/abecasis/MaCH/) based on the 1000-Genomes Project reference popula-
tion information (Abecasis et al., 2012). Genotype and individual quality controls have been
described in detail previously (Lango Allen et al., 2010). After all quality controls, the current study
included a total of 6,886,439 autosomal SNPs (MAF > 0.01, imputation R2 > 0.8, SNP call
rate > 0.97, HWE > 1e-4). The Rotterdam Study has been approved by the Medical Ethics Commit-
tee of the Erasmus MC (registration number MEC 02.1015) and by the Dutch Ministry of Health, Wel-
fare and Sport (Population Screening Act WBO, license number 1071272–159521 PG). The
Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; R; www.trial-
register.nl) an) and into the WHO International Clinical Trials Registry Platform (ICTRP; P; www.who.
int/ictrp/network/primary/en/) und under shared catalogue number NTR6831. All participants pro-
vided written informed consent to participate in the study and to have their information obtained
from treating physicians.
TwinsUK studyThe TwinsUK study included 1020 phenotyped participants (all female and all of Caucasian ancestry)
within the TwinsUK adult twin registry based at St. Thomas’ Hospital in London. All participants pro-
vided fully informed consent under a protocol reviewed by the St. Thomas’ Hosptal Local Research
Ethics Committee. Genotyping of the TwinsUK cohort was done with a combination of Illumina
HumanHap300 and HumanHap610Q chips. Intensity data for each of the arrays were pooled sepa-
rately and genotypes were called with the Illuminus32 calling algorithm, thresholding on a maximum
posterior probability of 0.95 as previously described (The MuTHER Consortium, 2011). Imputation
was performed using the IMPUTE 2.0 software package using haplotype information from the 1000
Genomes Project (Phase 1, integrated variant set across 1092 individuals, v2, March 2012). After all
quality controls, the current study included a total of 4,699,858 autosomal SNPs (MAF > 0.01, impu-
tation R2 > 0.8, SNP call rate > 0.97, HWE > 1e-4) and 1020 individuals.
ALSPAC studyThe Avon Longitudinal Study of Parents and Children (ALSPAC) is a longitudinal study that recruited
pregnant women living in the former county of Avon in the United Kingdom, with expected delivery
dates between 1st April 1991 and 31st December 1992. The initial number of enrolled pregnancies
was 14,541 resulting in 14,062 live births and 13,988 children alive at the age of 1. When the oldest
children were approximately 7 years of age, additional eligible cases who had failed to join the study
originally were added to the study. Full details of study enrolment have been described in detail pre-
viously (Boyd et al., 2013; Fraser et al., 2013; Golding et al., 2001). A total of 9,912 ALSPAC chil-
dren were genotyped using the Illumina HumanHap550 quad genome-wide SNP genotyping
platform. Individuals were excluded from further analysis based on incorrect sex assignments; het-
erozygosity (0.345 for the Sanger data and 0.330 for the LabCorp data); individual missingness
(>3%); cryptic relatedness (>10% IBD) and non-European ancestry (detected by a multidimensional
scaling analysis seeded with HapMap two individuals). The resulting post-quality control dataset con-
tained 8237 individuals. The post-quality control ALSPAC children were combined with the ALSPAC
mothers cohort (Fraser et al., 2013) and imputed together using a subset of markers common to
both the mothers and the children. The combined sample was pre-phased using ShapeIT (v2.r644)
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Research article Genetics and Genomics
(Delaneau et al., 2012) and imputed to the 1000 Genomes reference panel (Phase 1, Version3)
(Auton et al., 2015) using IMPUTE3 V2.2.2 (Howie et al., 2009). The present study sample included
3707 individuals with 3D facial images, genotype and covariate data. Ethical approval for the study
was obtained from the ALSPAC Ethics and Law Committee and the Local Research Ethics Commit-
tees. Please note that the study website contains details of all the data that is available through a
fully searchable data dictionary and variable search tool: http://www.bristol.ac.uk/alspac/research-
ers/our-data/.
Pittsburgh 3D Facial Norms (PITT) sample, United StatesThe current study included 2195 individuals from the 3D Facial Norms dataset (Weinberg et al.,
2016). These individuals were recruited at four US sites (Pittsburgh, Seattle, Houston, and Iowa
City), were of self-identified European ancestry, and ranged in age from 3 to 49 years. Exclusion cri-
teria included any individuals with a history of significant facial trauma, congenital defects of the
face, surgical alteration of the face, or any medical conditions affecting the facial posture. DNA was
extracted from saliva samples and genotyped along with 72 HapMap control samples for 964,193
SNPs on the Illumina (San Diego, CA) HumanOmniEx- press+Exome v1.2 array plus 4,322 SNPs of
custom content by the Center for Inherited Disease Research (CIDR). Samples were interrogated for
genetic sex, chromosomal aberrations, relatedness, genotype call rate, and batch effects. SNPs were
interrogated for call rate, discordance among duplicate samples, Mendelian errors among HapMap
controls (parent-offspring trios), deviations from Hardy-Weinberg equilibrium, and sex differences in
allele frequencies and heterozygosity. To assess population structure, we performed principal com-
ponent analysis (PCA) using subsets of uncorrelated SNPs. Based on the scatterplots of the principal
components (PCs) and scree plots of the eigenvalues, we determined that population structure was
captured in four PCs of ancestry. Imputation of unobserved variants was performed using haplotypes
from the 1000 Genomes Project Phase three as the reference. Imputation was performed using
IMPUTE2. We used an info score of > 0.5 at the SNP level and a genotype probability of > 0.9 at
the SNP-per-participant level as filters for imputed SNPs. Masked variant analysis, in which geno-
typed SNPs were imputed in order to assess imputation quality, indicated high accuracy of imputa-
tion. Institutional Review Board (IRB) approval was obtained at each recruitment center and all
subjects gave written informed consent prior to participation: University of Pittsburgh IRB
#PRO09060553 and IRB0405013; Seattle Children’s IRB #12107; University of Iowa Human Subjects
Office/IRB #200912764 and #200710721; UT Health Committee for the Protection of Human Sub-
jects #HSC-DB-09–0508 and #HSC-MS-03–090.
Xinjiang uyghur (UYG) studyThe UYG samples were collected at Xinjiang Medical University in 2013–2014. In total, 858 individu-
als (including 333 males and 525 females, with an age range of 17–25) were enrolled. The research
was conducted with the official approval from the Ethics Committee of the Shanghai Institutes for
Biological Sciences, Shanghai, China. All participants had provided written consent. All samples
were genotyped using the Illumina HumanOmniZhongHua-8 chips, which interrogates 894,517
SNPs. Individuals with more than 5% missing data, related individuals, and the ones that failed the
X-chromosome sex concordance check or had ethnic information incompatible with their genetic
information were excluded. SNPs with more than 2% missing data, with a minor allele frequency
smaller than 1%, and the ones that failed the Hardy–Weinberg deviation test (p<1e-5) were also
excluded. After applying these filters, we obtained a dataset of 709 samples with 810,648 SNPs for
the Uyghurs. The chip genotype data were firstly phased using SHAPEIT (O’Connell et al., 2014).
IMPUTE2 (Howie et al., 2009) was then used to impute genotypes at un-genotyped SNPs using the
1000 Genomes Phase three data as reference. Finally, a total of 6,414,304 imputed SNPs passed
quality control and were combined with 810,648 genotyped SNPs for further analyses.
CANDELA studyCANDELA samples (Ruiz-Linares et al., 2014) consist of 6630 volunteers recruited in five Latin
American countries (Brazil, Colombia, Chile, Mexico and Peru). Ethics approval was obtained from:
The Universidad Nacional Autonoma de Mexico (Mexico), the Universidad de Antioquia (Colombia),
the Universidad Peruana Cayetano Heredia (Peru), the Universidad de Tarapaca (Chile), the
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Research article Genetics and Genomics
Universidade Federal do Rio Grande do Sul (Brazil), and the University College London (UK). All par-
ticipants provided written informed consent. Individuals with dysmorphologies, a history of facial sur-
gery or trauma, or with BMI over 33 were excluded (due to the effect of obesity on facial features).
DNA samples were genotyped on Illumina’s Omni Express BeadChip. After applying quality control
filters 669,462 SNPs and 6357 individuals were retained for further analyses (2922 males, 3435
females). Average admixture proportions for this sample were estimated as: 48% European, 46%
Native American and 6% African, but with substantial inter-individual variation. After all genomic
and phenotypic quality controls this study included 5958 individuals. The genetic PCs were obtained
from the LD-pruned dataset of 93,328 SNPs using PLINK 1.9. These PCs were selected by inspecting
the proportion of variance explained and checking scatter and scree plots. The final imputed dataset
used in the GWAS analyses included genotypes for 9,143,600 SNPs using the 1000 Genomes Phase
I reference panel. Association analysis on the imputed dataset were performed using the best-guess
imputed genotypes in PLINK 1.9 using linear regression with an additive genetic model incorporat-
ing age, sex and five genetic PCs as covariates.
Queensland Institute of Medical Research (QIMR) studyAfter phenotype and genotype quality control, data were available for 1101 participants who were
mainly twins aged 16 years. All participants, and where appropriate their parent or guardian, gave
informed consent, and all studies were approved by the QIMR Berghofer Human Research Ethics
Committee. Participants were genotyped on the Illumina Human610-Quad and Core+Exome SNP
chips. Genotype data were screened for genotyping quality (GenCall < 0.7), SNP and individual call
rates (<0.95), HWE failure (p<1e-6) and MAF (<0.01). Data were checked for pedigree, sex and Men-
delian errors and for non-European ancestry. Imputation was performed on the Michigan Imputation
Server using the SHAPEIT/minimac Pipeline according to the standard protocols.
Facial shape phenotypingIn our study, we focused on 13 facial landmarks available in all cohorts with 3-dimensional digital
photographs. These included right (ExR) and left (ExL) exocanthion: points of bilateral outer canthus;
right (EnR) and left (EnL) endocanthion: points of bilateral inner canthus; nasion (Nsn): the point
where the bridge of the nose meets the forehead; pronasale (Prn): the point of the nose tip; subna-
sale (Sbn): the point where the base of the nasal septum meets the philtrum; right (AlR) and left (AlL)
alare: points of bilateral nose wing; labliale superius (Ls): the point of labial superius; labiale inferius
(Li): the point of labial inferius; right (ChR) and left (ChL) cheilion: points of bilateral angulus oris.
Slightly different image processing algorithms were applied to 3dMD images to capture facial land-
marks in the participating cohorts. In RS and TwinsUK, the raw 3D facial images were acquired using
a 3D photographic scanning system manufactured by 3dMD (http://www.3dmd.com/). Participants
were asked to keep their mouths closed and adopt a neutral expression during the acquisition of the
3D scans. Ensemble methods for automated 3D face landmarking were then used to derived 21
landmarks (de Jong et al., 2018; de Jong et al., 2016). In short, 3D surface model of participants’
face obtained with commercial photogrammetry systems for faces called 3dMDface were input to
the algorithm. Then a map projection of these face surfaces transformed the 3D data set into 3D
relief maps and 2D images were generated from these 3D relief maps. These images were subjected
to a 2D landmarking method like Elastic Bunch Graph Matching. Finally, registered 2D landmarks
are mapped back into 3D, inverting the projection. 13 shared facial landmarks coordinate data were
processed using GPA to remove variations due to scaling, shifting and rotation. Euclidean distances
were calculated between all landmarks. Outliers (>3 sd) were removed before the subsequent analy-
sis. Shapiro-Wilk test (Royston, 1995) was used to test the normality of phenotype distribution. At
15 years of age, the ALSPAC children were recalled (5253 attended) and 3D facial scans where taken
using two high-resolution Konica Minolta VI-900 laser scanners (lenses with a focal length 14.5 mm).
The set of left and right facial scans of each individual were processed, registered, and merged using
a locally developed algorithm implemented as a macro in Rapidform 2006 (Kau et al., 2004;
Paternoster et al., 2012; Toma et al., 2009). 22 landmarks were recorded manually. GPA was used
to remove affine variations due to shifting, rotation and scaling. 4747 individuals had usable images
(506 individuals did not complete the assessment or facial scans were removed due to poor quality).
The coordinates of 22 facial landmarks were derived from the scans, of which 13 were shared across
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Research article Genetics and Genomics
all other studies. 3D Euclidean distances were calculated between the facial landmarks. 3D facial
models from PITT were obtained with 3dMD digital stereo-photogrammetry systems. Facial land-
marks were collected on the facial surfaces by trained raters and assessed for common placement
errors during subsequent quality control. A set of 78 linear distance variables was then calculated
from a subset of 13 of these landmarks, chosen because they were shared among all of the discovery
cohorts in this study. These distances were screened for outliers. In UYG, the 3DMDface system
(www.3dmd.com/3dMDface) was used to collect high-resolution 3D facial images from participants.
A dense registration was applied to align all the 3D images as described elsewhere (Guo et al.,
2013). In brief, 15 salient facial landmarks were first automatically annotated based on the PCA pro-
jection of texture and shape information. Afterwards, a facial image of high quality and smooth
shape surface was chosen as the reference, and its mesh was re-sampled to achieve an even density
of one vertex in each 1mm � 1 mm grid. The reference face was then warped to register every sam-
ple face by matching all the 15 landmarks, via a non-rigid thin-plate spline (TPS) transformation. The
mesh points of the reference face were then projected to the sample surface to find their one-to-
one correspondents. The resulting points of projection were used to define the mesh of the sample
facial surface. After the alignment, each sample face was represented by a set of 32,251 3D points
and 15 target points were ready to be analyzed. A set of 78 linear distance variables was calculated
from a subset of 13 of these 15 landmarks. In CANDELA, ordinal phenotyping was described in prior
GWAS (Adhikari et al., 2016). In short, right side and frontal 2D photographs of participants were
used to score 14 facial traits, Intra-class correlation coefficients (ICCs) were calculated to indicate a
moderate-to-high intra-rater reliability of the trait scores. All photographs were scored by the same
rater. In QIMR, two independent researchers manually evaluated all 2D portrait photos and located
the coordinates for 36 facial landmarks. Satisfactory inter-rater concordance was obtained (Pearson’s
correlation coefficient, mean r = 0.76). The average landmark coordinates between the two research-
ers were used for Euclidian distance calculation.
Phenotype characteristicsPhenotype characteristics were explored for gender and aging effect, phenotypic and genetic corre-
lations, clustering, and twins-heritability. Gender and aging effects were estimated using beta, p,
and R2 values from linear models. Phenotypic correlations were estimated using Pearson’s correla-
tion coefficients. Genetic correlations were estimated using genome-wide SNPs and the multivariate
linear mixed model algorithm implemented in the GEMMA software package (Zhou & Stephens,
2014). Manual clustering was according to the involvement of intra- and inter- organ landmarks.
Unsupervised hierarchical clustering was conducted using the 1-abs(correlation) as the dissimilarity
matrix and each iteration was updated using the Lance - Williams formula (Ward, 1963). we calcu-
lated twins heritability for TwinsUK and QIMR twins using the phenotypic correlation derived from
monozygotic twins (MZ) and dizygotic twins (DZ), that is h2 ¼ 2 cor MZð Þ � cor DZð Þ½ �. SNP-based heri-
tability was estimated for twins cohorts using the restricted estimated maximum likelihood method
implemented in the GCTA software package (Yang et al., 2011).
GWAS, meta-analysis, and replication studiesGWASs for face phenotypes were independently carried out in RS, TwinsUK, ALSPAC, PITT, CAN-
DELA, UYG, and QIMR based on linear or logistic models assuming an additive allele effect adjusted
for potential confounders in each cohorts, such as family relationships, sex, age, BMI and genetic
PCs using software packages including PLINK (Purcell et al., 2007), GEMMA (Zhou and Stephens,
2012), and Rare Metal Worker (Feng et al., 2014). It should be noted that we used the scaled Gen-
eral Procrustes Analysis (GPA) to eliminate potential confounding effect of BMI although in some
cohorts BMI was additionally included as a covariate, which shouldn’t have affected the results of
our meta-analysis. For RS, association tests were run between the 78 3D facial distance measure-
ments (after scaled GPA) and 6,886,439 genotyped and imputed SNPs with MAF > 0.01, imputation
R2 > 0.8, SNP call rate > 0.97 and HWE > 0.0001. GWAS was performed using linear regression
under the additive genetic model while adjusting for sex, age, and the first four genomic PCs
derived using GCTA (Yang et al., 2011). For TwinsUK, quality control was performed on SNPs
(MAF > 0.01, imputation R2 > 0.8, SNP call rate > 0.99). One of each pair of monozygotic twins (MZ)
were excluded from association tests to reduce relatedness. The final sample included 1020
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Research article Genetics and Genomics
individuals and 4,699,859 autosomal genotyped and imputed variants. GWAS was performed
between the 78 3D facial distance measurements (after scaled GPA) and genotyped and imputed
SNPs using linear regression under the additive genetic model while adjusting for age and the first
four genomic PCs. For ALSPAC, 3941 study participants had both genotype and 3D facial pheno-
type data. GCTA was used to remove individuals with excessive relatedness (GRM > 0.05) and qual-
ity control was performed on SNPs (MAF > 0.01, imputation R2 > 0.8, SNP call rate > 0.99). The
final sample included 3707 individuals and 4,627,882 autosomal genotyped and imputed SNPs.
GWAS was performed between the 78 3D facial distance measurements (after scaled GPA) and gen-
otyped and imputed SNPs using linear regression under the additive genetic model while adjusting
for age, sex, and the first four genomic PCs using PLINK 1.9 (Purcell et al., 2007). For PITT, associa-
tion tests were run between the 78 3D facial distance measurements (after scaled GPA) and
9,478,231 genotyped and imputed SNPs with MAF > 1% and HWE > 0.0001. GWAS was performed
using linear regression under the additive genetic model while adjusting for sex, age, age2, height,
weight and the first four genomic PCs using PLINK 1.9. For the analysis of the X-chromosome, geno-
types were coded 0, 1, and two as per the additive genetic model for females, and coded 0, two for
males in order to maintain the same scale between sexes. Note that in the meta-analysis of all
cohorts, the X-chromosome was not included. For CANDELA, PLINK 1.9 was used to perform the
primary genome-wide association tests for each phenotype using multiple linear regression with an
additive genetic model incorporating age, sex, BMI and five genetic PCs as covariates. Association
analyses were performed on the imputed dataset with two approaches: using the best-guess
imputed genotypes in PLINK, and using the IMPUTE2 genotype probabilities in SNPTEST v2.5. Both
were consistent with each other and with the results from the chip genotype data. GWAS results
with using best-guess genotypes were used in the subsequent meta-analysis. For UYG, GWAS were
carried out using PLINK 1.9 and a linear regression model with additive SNP effects was used.
Details was described in prior GWAS (Qiao et al., 2018). For QIMR, the GWAS was conducted using
Rare Metal Worker with linear regression adjusted for sex, age, BMI and the first five genomic PCs.
Inverse variance fixed-effect meta-analysis were carried out using PLINK to combine GWAS
results for samples of European origin and having 3dMDface data, that is RS, TwinsUK, ALSPAC,
and PITT, which included 7,029,494 autosomal SNPs overlapping between the 4 discovery cohorts
with physical positions aligned according to NCBI human genome sequence build GRCh37.p13. X
chromosome was not included in meta-analyses. Summary statistics of all SNPs and all facial pheno-
types from the GWAS meta-analysis from the four cohorts of European descent (RS, TwinsUK,
ALSPAC and PITT) are available via figshare https://doi.org/10.6084/m9.figshare.10298396 and will
be made available through the NHGRI-EBI GWAS Catalog https://www.ebi.ac.uk/gwas/downloads/
summary-statistics. Meta-analysis results were visualized using superposed Manhattan plots and Q-Q
plots. All genomic inflation factors were close to 1 and not further considered. Because many of the
78 facial phenotypes were correlated, we applied the matrix decomposition method described by
Li and Ji (2005) to determine the effective number of independent phenotypes as 43. We then set
our study-wide significant threshold at p<1.2�10�9 using Bonferroni correction of 43 phenotypes,
considering significant threshold for single phenotype GWAS as P<5�10�8). We considered the
threshold of 5�10�8 as the threshold for replication studies in CANDELA, UYG, and QIMR. Since the
3dMDface data were available in UYG, exact replications were conducted, that is the genetic associ-
ation was tested for the corresponding phenotypes in the meta-analysis. Since only 2D photos were
available in CANDELA and QIMR, trait-wise replications were conducted to test H0: no association
for all face phenotypes vs. H1: associated with at least one face phenotypes. We used a combined
test of dependent tests to combine genetic association tests involving highly correlated face pheno-
types (Kost and McDermott, 2002). In short, the test statistic of the combined test follows a scaled
chi-squared distribution when tests are dependent. The mean of the �2 values is:
E �2ð Þ ¼ 2k, and the variance can be estimated as
var �2ð Þ ¼ 4kþ 2
P
1�i<j�k cov �2logPi; � 2logPj
� �
, where
k is the number of phenotypes, Pi is the p value of the ith test. The covariance term
cov �2logPi; � 2logPj
� �
can be approximated by the following formula using the phenotype correla-
tion matrix:
cov �2logPi; � 2logPj
� �
»3:263rijþ 0:71r2ij þ 0:027r3ij
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Research article Genetics and Genomics
This approximation has been shown nearly identical to the exact value with difference less than
0.0002 for �0.98 <rij < 0.98 (Kost and McDermott, 2002). We then again used the combined test
of dependent tests to combine replication evidence from all three cohorts. Multiple testing was cor-
rected for the number of selected SNPs using the Bonferroni method. Regional linkage disequilib-
rium r2 values were calculated in PLINK and visualized using R scripting. Regional association plots
were produced using LocusZoom (Pruim et al., 2010).
Genetic diversity and positive selection signal analysisTo test for signals of allele frequency diversity and positive selection in the face associated genomic
regions, we derived two commonly used statistics in population genetics, that is the fixation index
(FST) and the integrated haplotype score (iHS) for all SNPs in the associated regions. The FST is a
parameter in population genetics for quantifying the differentiation due to genetic structure
between a pair of groups by measuring the proportion of genetic diversity due to allele frequency
differences among populations potentially as a result of divergent natural selection (Holsinger and
Weir, 2009). We performed a genome-wide FST analysis for three pairs of populations (AFR-EAS,
EAS-EUR, and EUR-AFR) in the samples from the 1000 Genome Project using the PLINK software.
The empirical significance cutoff for each of the three population pairs was set to the value corre-
sponding to the top 1% FST values in the genome. The iHS is the integrate of the extended haplo-
type homozygosity (EHH) statistic to highlight recent positive selected variants that have not yet
reached fixation, and large values suggest the adaption to the selective pressures in the most recent
stage of evolution (Sabeti et al., 2002; Voight et al., 2006). The EHH statistic was calculated for all
SNPs in AFR, EAS and EUR samples. Then the iHS statistic, integral of the decay of EHH away from
each SNP until EHH reaches 0.05, was calculated for all SNPs, in which an allele frequency bin of
0.05 was used to standardize iHS scores against other SNPs of the same frequency class. Finally, we
calculated empirical significance threshold over the genome assuming a Gaussian distribution of iHS
scores under the neutral model. The cutoff was based on the top 1% absolute iHS scores calculated
in three samples respectively as the absolute score indicate the selection intensity.
Multivariable and polygenic score (PS) analysisMultivariable and polygenic score analyses were conducted in the RS cohort. For all SNPs showing
study-wide suggestively significant association with face phenotypes (p<5x10�8), we performed a
multivariable regression analysis aiming to select SNPs that still be significant after regressing out
the effects of the 24 lead SNPs by including them as covariates in the model, which resulted in 31
SNPs for the subsequent modeling. A forward step-wise regression was conducted to access the
independent effects of the selected SNPs on sex- and age- adjusted face phenotypes, where the R2
contribution of each SNP was estimated by comparing the current model fitting R2 with the R2 in a
previous iteration. Next, we calculated PS for AFR, EUR, EAS individuals of the 1000 Genomes Proj-
ect using the selected SNPs and the effect sizes estimated from the multivariable analysis, that is
PS ¼P
n
i¼1biAi. The mean values and distributions of the standardized PS values for all face pheno-
types in each continental group was visualized using a face map and multiple boxplots, in which the
differences between groups were highlighted according to the p-values from the ANOVA test, which
tests H0: PS values are the same in all continental groups and H1: PS values are different in at least
one of the groups.
Gene ontology analysis, expression analysis and SNP functionalannotationTo further study the involved functions and regulation relationships of the genome-wide significantly
associated SNP markers and candidate genes nearby, the genes located within 100 kb up- and
down-stream of the SNPs were selected to perform biological process enrichment analysis based on
the Gene Ontology (GO) database. The enrichment analysis was performed using the R package
‘clusterProfiler’ (Yu et al., 2012). RNA-seq data from the study of Prescott et al. (2015), GTEx
(Lonsdale et al., 2013) and ENCODE (ENCODE Project Consortium, 2012) were used to compare
the differences in gene expression levels between our face-associated genes and all genes over the
genome in CNCCs. We examined entries in GWAS catalog (Welter et al., 2014) to explore the
potential pleotropic effects in our face associated regions. The GTEx (Lonsdale et al., 2013) dataset
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Research article Genetics and Genomics
was used to annotate our face associated SNPs for significant single-tissue cis-eQTL effects in all 48
available tissues. We used the CNCC data from Prescott et al. and UCSC (Aken et al., 2016) to per-
form a variety of functional annotations for the face associated SNPs in non-coding regions using the
WashU Epigenome Browser, including histone modifications (H3K27ac, H3K4me1 and H3K4me3
tracks), chromatin modifier (p300 tracks), transcription factors (TFAP2A tracks), chromatin accessibil-
ity (ATACseq tracks) and conserved regions (PhyloP (Siepel et al., 2005) tracks) from UCSC. To
investigate the pattern of regulation within each association region in details, we calculated the log
scaled quantile rank and variation of all LD SNP (r2 > 0.25) in three replicated measurements from 6
types of Chip-seq data, and for all significant base-pair in vicinity (within 20 kb) of all top-associated
SNPs. All analyses were conducted using R Environment for Statistical Computing (version 3.3.1)
unless otherwise specified.
Cell cultureNeural progenitors were derived from human induced pluripotent stem cells as described previously
(male, age 57 years, derived from primary skin fibroblasts) (Gunhanlar et al., 2018). Written
informed consent was obtained in accordance with the Medical Ethical Committee of the Erasmus
University Medical Center. Neural progenitors contain a subpopulation of neural crest progenitor
cells that were enriched by fluorescence-activated cell sorting for CD271 (BD Bioscience 560927, BD
FACSAria III) (Dupin and Coelho-Aguiar, 2013; Lee et al., 2007). CD271 (p75) is a surface antigen
marking neural crest progenitor cells which give rise to craniofacial tissues as well as melanocyte pri-
mary cells (Morrison et al., 1999). CD271+ cells were grown in DMEM:F12, 1% N2 supplement, 2%
B27 supplement, 1% P/S, 20 ng/ml FGF at 37˚C/5% CO2. G361 cells were cultured in DMEM/10%
FCS at 37˚C/5% CO2. The cell line was tested negative for mycoplasma contamination and its iden-
tity was authenticated by STR profiling using PowerPlex 16 System (Promega).
In vitro functional experiments: Luciferase reporter assayWe explored the effect of the five selected SNPs on gene expression in CD271+ and G361 mela-
noma cells by a luciferase reporter assay. Custom 500 bp gBlocks Gene fragments (IDT) containing
putative enhancers surrounding each of the five selected SNPs were cloned into a modified pGL3
firefly luciferase reporter vector (SV40 promoter and 3´UTR replaced by HSP promoter and 3´UTR).
For each SNP, constructs containing both ancestral and derived alleles were tested. Equimolar
amount of constructs (measured by qPCR detecting the firefly luciferase gene using GoTaq qPCR
Master Mix (Promega) were co-transfected with renilla luciferase control vector into CD271+ and
G361 cells using Lipofectamine LTX (Invitrogen). Luciferase activity was measured 48 hr after trans-
fection using the Dual-Glo Luciferase Assay System (Promega). Data are presented as relative lucifer-
ase activity (firefly/renilla activity ratio) fold change compared to the construct containing the less
active allele and represent at least three independent replicates. Student´s t-test was performed to
test differences in gene expression. The Key Resources Table summarizing reagents and resources
used in the in-vitro functional experiments is included in the Supplementary file 1 - Table 19 (see
Supplementary file 1).
AcknowledgementsWe are grateful to all participants and their families who took part in the RS, TwinsUK, ALSPAC,
PITT, UYG, CANDELA, and QIMR studies as well as the many individuals involved in the running of
the studies and recruitment, which include midwives, interviewers, computer and laboratory techni-
cians, clerical workers, research scientists, volunteers, managers, receptionists, nurses and other pro-
fessional. MK additionally thanks Maren von Kockritz-Blickwede for earlier discussions on PAD
knockout mice. QIMR would like to thank Natalie Garden and Jessica Adsett for data collection and
Scott Gordon for data management.
The ALSPAC study was supported by The UK Medical Research Council and Wellcome (Grant
ref: 102215/2/13/2) and the University of Bristol. A comprehensive list of grants funding for ALSPAC
is available online (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.
pdf). This publication is the work of the authors and L.H. and E.S. will serve as guarantors for the
contents of this paper. GWAS data was generated by Sample Logistics and Genotyping Facilities at
Wellcome Sanger Institute and LabCorp (Laboratory Corporation of America) using support from
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 22 of 32
Research article Genetics and Genomics
23andMe. The TwinsUK study was supported by the Wellcome Trust, Medical Research Council,
European Union (FP7/2007-2013), the National Institute for Health Research (NIHR)-funded BioRe-
source, Clinical Research Facility and Biomedical Research Centre based at Guy’s and St Thomas’
NHS Foundation Trust in partnership with King’s College London. The Rotterdam Study is sup-
ported by the Erasmus MC and Erasmus University Rotterdam; the Netherlands Organization for Sci-
entific Research (NWO); the Netherlands Organization for Health Research and Development
(ZonMw); the Research Institute for Diseases in the Elderly (RIDE) the Netherlands Genomics Initia-
tive (NGI); the Ministry of Education, Culture and Science; the Ministry of Health Welfare and Sport;
the European Commission (DG XII); and the Municipality of Rotterdam. The generation and manage-
ment of GWAS genotype data for the Rotterdam Study were executed by the Human Genotyping
Facility of the Genetic Laboratory of the Department of Internal Medicine, Erasmus MC. For the
CANDELA study, the following institutions kindly provided facilities for the assessment of volun-
teers: Escuela Nacional de Antropologıa e Historia and Universidad Nacional Autonoma de Mexico
(Mexico); Pontificia Universidad Catolica del Peru, Universidad de Lima and Universidad Nacional
Mayor de San Marcos (Peru); Universidade Federal do Rio Grande do Sul (Brazil); 13˚ Companhia de
Comunicacoes Mecanizada do Exercito Brasileiro (Brazil). The PITT study received additional sup-
port from The Centers for Disease Control and Prevention (https://www.cdc.gov/) provided funding
through the following grant: R01- DD000295. Funding for initial genomic data cleaning by the Uni-
versity of Washington was provided by contract #HHSN268201200008I from the National Institute
for Dental and Craniofacial Research (http://www.nidcr.nih.gov/) awarded to the Center for Inherited
Disease Research (CIDR). The QIMR study received additional support by an Australian Research
Council Linkage Grant (LP 110100121 to Dennis McNevin, University of Canberra).
Additional information
Funding
Funder Grant reference number Author
Horizon 2020 - Research andInnovation Framework Pro-gramme
740580 (VISAGE) Manfred Kayser
National Science Foundationof China
91651507 Fan Liu
Chinese Academy of Sciences Strategic Priority ResearchProgram (XDC010400100)
Fan Liu
China Scholarship Council PhD Fellowship Ziyi Xiong
Netherlands Organisation forScientific Research
1750102005011 M Arfan Ikram
Wellcome Trust Timothy D Spector
Medical Research Council 102215/2/13/2 Evie Stergiakouli
National Institute of Dentaland Craniofacial Research
U01-DE020078 Mary L MarazitaSeth M Weinberg
Leverhulme Trust F/07 134/DF Andres Ruiz-Linares
National Natural ScienceFoundation of China
91631307 Sijia Wang
National Natural ScienceFoundation of China
91731303 Shu-Hua Xu
National Natural ScienceFoundation of China
30890034 Li Jin
National Health and MedicalResearch Council
APP103119 Nicholas G Martin
National Health and MedicalResearch Council
Fellowship (APP1103623) Sarah E Medland
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 23 of 32
Research article Genetics and Genomics
National Natural ScienceFoundation of China
31771388 Shu-Hua Xu
National Natural ScienceFoundation of China
315014 Shu-Hua Xu
National Natural ScienceFoundation of China
31711530221 Shu-Hua Xu
National Natural ScienceFoundation of China
31271338 Li Jin
National Institute of Dentaland Craniofacial Research
R01-DE027023 John R ShafferSeth M Weinberg
National Institute of Dentaland Craniofacial Research
R01-DE016148 Mary L MarazitaSeth M Weinberg
National Institute of Dentaland Craniofacial Research
X01-HG007821 Eleanor FeingoldMary L MarazitaSeth M Weinberg
Netherlands Organisation forScientific Research
911-03-012 M Arfan Ikram
Ministry of Science and Tech-nology of the People’s Repub-lic of China
National Key R&D Programof China (2017YFC083501)
Fan Liu
Shanghai Municipal Scienceand Technology Commission
Major Project2017SHZDZX01
Sijia WangShu-Hua Xu
BBSRC BB/I021213/1 Andres Ruiz-Linares
Universidad de Antioquia CPT-1602, Estrategia parasostenibilidad 2016-2018grupo GENMOL
Gabriel Bedoya
Science and Technology Com-mission of Shanghai Munici-pality
16JC1400504 Li JinSijia Wang
Chinese Academy of Sciences QYZDJ-SSW-SYS009 Shu-Hua Xu
National Basic Research Pro-gram of China
2015FY111700 Li JinSijia Wang
National Key Research andDevelopment Program China
2016YFC0906403 Shu-Hua Xu
National Key Research andDevelopment Program China
2017YFC0803501-Z04 Kun Tang
National Program for Top-notch Young Innovative Ta-lents of The “Wanren Jihua”Project China
Shu-Hua Xu
Thousand Talents Plan Sijia Wang
Max Planck-CAS Paul GersonUnna Independent ResearchGroup Leadership Award
Sijia Wang
Medical Research Council MC_UU_00011/1 Laurence J HoweSarah LewisGemma C SharpEvie Stergiakouli
Medical Research Council Timothy D Spector
Netherlands Organisation forScientific Research
175.010.2005.011 Andre G Uitterlinden
Netherlands Organisation forScientific Research
911-03-012 Andre G Uitterlinden
Netherlands Organisation forScientific Research
050-060-810 Andre G Uitterlinden
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 24 of 32
Research article Genetics and Genomics
Netherlands Genomics Initia-tive
050-060-810 Andre G Uitterlinden
The funders had no role in study design, data collection and interpretation, or the
decision to submit the work for publication.
Author contributions
Ziyi Xiong, Data curation, Software, Formal analysis, Funding acquisition, Investigation, Visualization,
Methodology, Manuscript preparation and revision, Final approval of the version to be published;
Gabriela Dankova, Data curation, Formal analysis, Investigation, Visualization, Methodology, Data
acquisition, Manuscript preparation and revision, Final approval of the version to be published; Lau-
rence J Howe, Data curation, Formal analysis, Investigation, Funding acquisition, Manuscript prepa-
ration, Final approval of the version to be published; Myoung Keun Lee, Pirro G Hysi, Data curation,
Formal analysis, Investigation, Final approval of the version to be published; Markus A de Jong,
Data curation, Software, Formal analysis, Investigation, Data acquisition, Final approval of the version
to be published; Gu Zhu, Kaustubh Adhikari, Data curation, Formal analysis, Validation, Investigation,
Final approval of the version to be published; Dan Li, Formal analysis, Validation, Investigation, Final
approval of the version to be published; Yi Li, Bo Pan, Formal analysis, Investigation, Final approval
of the version to be published; Eleanor Feingold, Data curation, Formal analysis, Final approval of
the version to be published; Mary L Marazita, Resources, Data curation, Data acquisition, Final
approval of the version to be published; John R Shaffer, Resources, Data curation, Formal analysis,
Funding acquisition, Final approval of the version to be published; Kerrie McAloney, Resources,
Data curation, Formal analysis, Validation, Final approval of the version to be published; Shu-Hua
Xu, Li Jin, Resources, Supervision, Funding acquisition, Validation, Project administration, Data
acquisition, Final approval of the version to be published; Sijia Wang, Resources, Data curation,
Supervision, Funding acquisition, Validation, Project administration, Data acquisition, Final approval
of the version to be published; Femke MS de Vrij, Bas Lendemeijer, Resources, Investigation, Final
approval of the version to be published; Stephen Richmond, Resources, Supervision, Investigation,
Data acquisition, Manuscript preparation, Final approval of the version to be published; Alexei
Zhurov, Data curation, Formal analysis, Investigation, Data acquisition, Final approval of the version
to be published; Sarah Lewis, Resources, Data curation, Investigation, Funding acquisition, Final
approval of the version to be published; Gemma C Sharp, Resources, Data curation, Investigation,
Funding acquisition, Project administration, Final approval of the version to be published; Lavinia
Paternoster, Resources, Data curation, Supervision, Project administration, Final approval of the ver-
sion to be published; Holly Thompson, Resources, Data curation, Supervision, Final approval of the
version to be published; Rolando Gonzalez-Jose, Maria Catira Bortolini, Samuel Canizales-Quinteros,
Carla Gallo, Giovanni Poletti, Francisco Rothhammer, Resources, Data curation, Validation, Data
acquisition, Final approval of the version to be published; Gabriel Bedoya, Resources, Data curation,
Validation, Data acquisition, Funding acquisition, Final approval of the version to be published;
Andre G Uitterlinden, Resources, Supervision, Funding acquisition, Project administration, Data
acquisition, Final approval of the version to be published; M Arfan Ikram, Resources, Data curation,
Supervision, Funding acquisition, Final approval of the version to be published; Eppo Wolvius, Ste-
ven A Kushner, Resources, Supervision, Final approval of the version to be published; Tamar EC Nijs-
ten, Resources, Data curation, Supervision, Project administration, Data acquisition, Final approval of
the version to be published; Robert-Jan TS Palstra, Conceptualization, Resources, Supervision, Meth-
odology, Data acquisition, Final approval of the version to be published; Stefan Boehringer, Concep-
tualization, Resources, Software, Supervision, Methodology, Data acquisition, Final approval of the
version to be published; Sarah E Medland, Resources, Supervision, Funding acquisition, Validation,
Data acquisition, Final approval of the version to be published; Kun Tang, Data curation, Formal
analysis, Funding acquisition, Validation, Investigation, Methodology, Data acquisition, Final
approval of the version to be published; Andres Ruiz-Linares, Resources, Supervision, Funding acqui-
sition, Validation, Project administration, Data acquisition, Manuscript preparation, Final approval of
the version to be published; Nicholas G Martin, Conceptualization, Resources, Data curation, Super-
vision, Funding acquisition, Validation, Methodology, Project administration, Data acquisition, Manu-
script preparation, Final approval of the version to be published; Timothy D Spector,
Conceptualization, Resources, Data curation, Supervision, Funding acquisition, Methodology, Project
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 25 of 32
Research article Genetics and Genomics
administration, Data acquisition, Manuscript preparation, Final approval of the version to be pub-
lished; Evie Stergiakouli, Seth M Weinberg, Resources, Data curation, Supervision, Funding acquisi-
tion, Methodology, Project administration, Data acquisition, Manuscript preparation, Final approval
of the version to be published; Fan Liu, Conceptualization, Resources, Software, Supervision, Fund-
ing acquisition, Visualization, Methodology, Data acquisition, Manuscript preparation and revision,
Final approval of the version to be published; Manfred Kayser, Conceptualization, Resources, Super-
vision, Funding acquisition, Methodology, Project administration, Data acquisition, Manuscript prep-
aration and revision, Final approval of the version to be published
Author ORCIDs
Kaustubh Adhikari https://orcid.org/0000-0001-5825-4191
Mary L Marazita https://orcid.org/0000-0002-2648-2832
John R Shaffer https://orcid.org/0000-0003-1897-1131
Femke MS de Vrij https://orcid.org/0000-0003-0825-3806
Gemma C Sharp https://orcid.org/0000-0003-2906-4035
Carla Gallo https://orcid.org/0000-0001-8348-0473
Steven A Kushner https://orcid.org/0000-0002-9777-3338
Stefan Boehringer https://orcid.org/0000-0001-9108-9212
Manfred Kayser https://orcid.org/0000-0002-4958-847X
Ethics
Human subjects: All cohort participants gave informed consent and consent to publish. The different
cohort studies involved have been approved by their local ethics committees and in part higher insti-
tutions such as ministries, as described in the Materials and methods section. Protocol numbers can
be found for each cohort in the Materials and methods section.
Decision letter and Author response
Decision letter https://doi.org/10.7554/eLife.49898.sa1
Author response https://doi.org/10.7554/eLife.49898.sa2
Additional filesSupplementary files. Supplementary file 1. Supplementary Tables. Includes: Supplementary Table 1. Characteristics of
the all cohorts. Supplementary Table 2 Characteristics of 78 facial phenotypes in RS. Supplementary
Table 3 Effects of 6 covariates to 78 facial phenotypes in RS. Supplementary Table 4. Phenotype cor-
relations between all facial phenotypes in RS. Supplementary Table 5. Genetic correlation between
all facial phenotypes in RS. Supplementary Table 6. Twins heritability and SNP-based heritability of
all facial phenotypes in TwinsUK and QIMR. Supplementary Table7. 494 SNPs associated (p<5e-8)
with facial shape phenotypes in meta-analysis of GWAS. Supplementary Table 8. Replication of
reported variants of facial variation. Supplementary Table 9. GWAS Catalog entries (release on
2018-01-01), for polymorphisms that were significantly associated with facial traits in meta-analyses.
Supplementary Table 10. Significant pleiotropic effect of study-wide suggestive SNPs on GeneAT-
LAS traits. Supplementary Table 11. Frequency distribution of 24 top-associated SNPs. Supplemen-
tary Table 12. Population differentiation and positive selection at the suggestive significant GWAS
SNPs. Supplementary Table 13. Replication of reported variants of NSCL/P trait. Supplementary
Table 14. Multiple linear regression for 31 top-associated SNPs fitting with SEX and AGE in RS. Sup-
plementary Table 15. Enrichment of the genes annotating the associated 24 regions. Supplementary
Table 16. Significant expression quantitative trait loci effects for 494 SNPs significantly associated
with facial traits and the target genes. Supplementary Table 17. Overviews of 5 selected candidate
regulatory SNPs. Supplementary Table 18. Luciferase reporter assay results overview presented as
relative luciferase activity fold change compared to construct containing less active allele ± standard
deviation. Supplementary Table 19. Key Resource Table for functional experiments.
. Transparent reporting form
Xiong et al. eLife 2019;8:e49898. DOI: https://doi.org/10.7554/eLife.49898 26 of 32
Research article Genetics and Genomics
Data availability
GWAS meta-analysis summary statistics data of the significantly associated SNPs are provided with
the paper in the supplementary file 1. In addition, GWAS meta-analysis summary statistics of all
SNPs and all facial phenotypes, including for each SNP the effect allele, non-effect allele and for
each phenotype the effect size aligned to the effect allele with standard error and p-value, are made
publicly available via figshare under https://doi.org/10.6084/m9.figshare.10298396 (updated file).
Moreover, after the paper is accepted for publication, we will upload to the EBI GWAS Catalogue
the complete summary statistics of all SNPs (same information as on figshare now) into the GWAS
Catalogue. We included this information and the website links in the Material and Method section.
The following dataset was generated:
Author(s) Year Dataset title Dataset URLDatabase andIdentifier
Manfred Kayser 2019 GWAS facial shape variation inhumans
https://doi.org/10.6084/m9.figshare.10298396
figshare, 10.6084/m9.figshare.10298396
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